Comfort and Compassion at the End of Life [Joanie Holm]

Hi, I'm Joanie Holm. I'm a retired pediatric nurse practitioner. And I work part time at the Brookings Health System in cardiac rehab.

Why was Dr. Holm so passionate about hospice?

My husband, Rick, was an internal medicine doctor, and he was the first hospice director. And he had a very positive philosophy and spiritual understanding of death. And so, he just saw hospice as the practical solution of helping people through their death.

How long was your husband treated for pancreatic cancer before receiving hospice care?

He lived for almost three years with the diagnosis, he did chemo, radiation, surgery, more chemo. And with that diagnosis, as most people will recognize it, it generally is a 7% survival rate, let's put it that way. So, you know, so high mortality. And he was an optimist, and kept his chin up, and went through the treatment, just fantastic. When treatment was failing, and we had run out of options is when he agreed that it was time to call hospice and was comfortable calling hospice. And, you know, at that point, he wasn't on any life saving treatments, he was just on treatments for comfort.

When is the right time to call hospice?

You know, hospice is not just about those last moments of dying. Hospice is about the care leading up to, and can be and in my opinion should be called when you decide to stop treatment. Now, it doesn't mean that your loved one is going to die within a day, or a week, or a month. But when you're not choosing to do life saving treatment, there are options to help you just to increase your knowledge, to help with comfort, to help with any equipment you might need. So, calling hospice before the end is really important. They're going to tell you if this isn't the time, or they're gonna start services gradually and up the services as needed. So, if in doubt, or if in question, call a hospice, they're gonna give you an honest answer on if this is the right thing for you.

How does hospice improve everyone's quality of life?

Hospice helped Rick's quality of life by helping our quality of life, A, by giving us resources, helping us if we needed a hospital bed, in our case we chose to bring our own bed down, but to bring equipment that we might need to educate us, to educate the children, and to be a comfort and resource if we needed staff, if we need personnel. So they helped in particular Rick's quality of health by bringing us medication and teaching us how to use it, reassuring us that in the end, there's not too much medication, it's okay to use it. They just made the process of his final days, final hours easier.

How did hospice help your children?

To have the hospice staff spend time with them, and talk to them about what to expect with their dad was really valuable. And just to talk about what to expect. You know, they didn't know what to expect, besides that one of my sons is a nurse. But just to know that we were gonna help dad, he was not gonna be in pain, that the nurse was going to be there anytime we needed her, that she could come over at any time, that she could help with medication, she could help with any of the equipment, just to let them know that there was backup if we felt uncomfortable, and it gave them a lot of comfort. She talked about...and I think they knew from their dad that always talk to him, always assume that he's hearing us, and they did. I mean, the day of Rick's death the whole family was with him and my son had read him a story that morning, he just read it out loud before anybody was awake. And then we were all with him. We had music going, we were singing. And so, it was...that the hospice staff had really prepared us.

How did hospice make the final days comfortable?

His final days, final moments were very peaceful. He basically...there was no agonizing pain. He was comfortable. He was with us. He he gave me a kiss, like just before he died. I told him I loved him and, you know, you never wanna lose somebody you love so much and is so much a part of your life, but it couldn't have been a lot better than what it was if you have to go through it. So I'm thankful for all of the medical care that was provided to Rick, all of the nursing care, the nurses, as a nurse of course I have that viewpoint of watching how loving everybody was with him, how loving the hospice staff and it's not an easy thing, but hospice was a big help to us.

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